Birth Control for Men Exists — But for Penis Havers, It’s Still Non-Hormonal

Your options at a glance

We’ll break down each method in-depth in a sec, but first, a quick chart to show your options at a glance.

What are your options if you have a penis and testicles?

If you have a penis and testicles, it’s pretty slim pickins at the moment.

External condoms

Unlike your other birth control options, condoms provide protection against sexually transmitted infections (STIs). *High five*

Plus, they come in different sizes and feels which can up the pleasure for some during a visit to Pound Town and other sex acts.

As far as preventing pregnancy, they’re effective but by no means foolproof. With perfect use, they’re 97 percent effective. That drops to 86 percent with typical use.

FYI, typical use factors in human error, like inconsistency or using it wrong.

Vasectomy

Vasectomy is an option for people with testicles. While the most effective option outside of abstinence, it’s a tad, er, invasive and ~technically~ considered a permanent birth control solution.

It involves cutting or blocking the tubes that carry sperm from the testicles to the penis to stop sperm from being added to ejaculate.

Three months post-snip, a doctor or other healthcare professional will confirm that your little swimmers have indeed been banned from your spunk. Until then, you’ll need backup birth control.

PSA: Withdrawal isn’t a reliable birth control method

Also called the pullout method, withdrawal involves pulling your peen out before you ejaculate. It’s your least effective option.

Even with perfect use, it isn’t 100 percent effective. One in 5 people (22 percent) who rely on it become pregnant.

Nailing the timing of withdrawal while nailing someone isn’t always as easy as it sounds. Plus, precum — which you don’t have any control over — can cause pregnancy.

Why are there only two options for folks who have a penis and testicles?

The release of the birth control pill in the 60s was revolutionary, but it also set the narrative that the responsibility to control pregnancy falls mainly on the person who can become pregnant.

While birth control options for cisgender men and other people assigned male at birth (AMAB) have been researched for almost as long as the pill’s been around, the ‘if it ain’t broke don’t fix it’ mentality has made it slow going, to say the least.

It’s not all doom and gloom; there are some options in the pipeline, including both hormonal and non-hormonal methods.

Male birth control pill

The news about a male birth control pill is promising, though getting one to the market is still several years off.

In 2019, a male birth control pill passed its first round of clinical testing. The daily pill, which suppresses two types of male hormones to decrease sperm and testosterone, was shown to be well tolerated.

Just recently, a group of scientists from the United States and China discovered a compound from a Chinese herb that disables sperm function in mice and monkeys.

Topical gel

A topical male reversible contraceptive gel is currently in Phase 2 testing.

The hormonal gel is applied to the shoulders of the male partner every morning to prevent the testes from making sperm.

Injectable gels

There are two injectable contraceptive gels in the pipeline that work like vasectomies minus the need for an incision. Researchers refer to these as non-scalpel vasectomies.

Both gels, which include Vasalgel and RISUG (Reversible Inhibition of Sperm Under Guidance), are injected into the scrotum to block sperm. RISUG is currently in Phase 3 clinical trials.

PSA: Abstinence and outercourse are only reliable if you are

Abstinence and outercourse are as reliable at preventing birth as you are to committing to them. As long as no P-in-V sex happens and no ejaculate gets into the vagina, you’re good.

What are your options if you have a uterus, ovaries, and a vagina?

The world of birth control is your proverbial oyster if you have a uterus, ovaries, and a vagina.

The options are the same if you’re taking testosterone. Hormonal birth control won’t affect hormone therapy.

Internal condoms

Internal condoms are non-latex pouches that you insert into the vagina (or anus!) before sex — up to 8 hours before if you’d like.

You get double the bang for your buck with these because they decrease the risk of pregnancy (95 percent effective with perfect use and 79 percent with typical use) and STIs.

Diaphragm

A diaphragm is a soft, reusable silicone disk that you saturate with spermicide and insert into the vagina where it plays gatekeeper to your cervix to keep sperm out.

Efficacy ranges from 88 to 94 percent with typical and perfect use, respectively.

Sponge

This squishy, spermicide-saturated disk sits deep in the vagina, covering your cervix and killing any sperm that attempts to get in.

Well, 76 to 88 percent of the time depending on a few variables, including whether or not you’ve ever given birth.

Once in, the sponge needs to stay in for 6 hours after penis-in-vagina sex, which can feel a bit icky. Silver lining: You can wear it up to 24 hours and enjoy it for several rounds o’ fun.

Cervical cap

A cervical cap — which looks just like a little hat for your cervix — gets filled (by you) with spermicide and then inserted to cap your cervix with a layer of sperm-killing protection.

Like the sponge, effectiveness varies (71 to 86 percent) between perfect and typical use, and whether or not you’ve ever given birth.

Spermicide

Spermicide does a bang up job with the insertable methods we just covered, but can be used on its own with an efficacy of 72 percent.

It’s available in different forms, like gels, foams, and suppositories (oh my!) and is available over the counter (OTC).

Shot

The shot is an injection of the hormone progestin and it works by preventing ovulation.

You get it at the doctor’s office every 90 days. It’s 99 percent effective when you’re good about keeping your scheduled jabs. Typical use efficacy is 94 percent.

Users report perks like lessened cramps and menstrual flow, or a stopped period altogether. Yes, please!

Ring

Better than any pieces in your jewelry box, you insert this hormonal ring into your vagina every 3 weeks to prevent ovulation and therefore pregnancy.

When used perfectly, it’s 99 percent effective. With typical use (which is what usually happens IRL), it’s more like 91 percent.

Patch

The patch is like a topical birth control. You slap it on your skin and the estrogen and progestin are absorbed into your body for a week’s worth of pleasure until it’s time to peel it off and apply another.

It’s between 99 and 91 percent effective depending how perfectly — or not — you use it.

Combination pill

This pill’s a combo of estrogen and progestin (hence the name) and needs to be taken every single day at around the same time to work to its 99 percent effectiveness.

Typical use brings it down to 91 percent effectiveness.

Minipill

The minipill is a progestin-only contraceptive pill. It’s on par with the combo pill as far as how effective it is — 99 percent with perfect use and 91 percent with typical use.

It’s a good way to go if you want to avoid estrogen.

Implant

This tiny implant is a fave because it’s discreet, more than 99 percent effective, and works for up to 3 years.

It’s an effective no-estrogen option if that’s your preference.

Copper IUD

Copper IUDs are also called non-hormonal IUDs and use the power of copper — which sperm hate apparently — to scare them off in the other direction.

Perks: They’re hormone-free, over 99 percent effective, and they can stay in for 10+ years. Wowza!

The main downside to IUDs is they need to be inserted by a healthcare professional.

Hormonal IUD

Hormonal IUDs contain progestin only and continue to work for up to 7 years after insertion. They’re over 99 percent effective.

If avoiding estrogen or the possibility of stopping your periods altogether appeals to you, a hormonal IUD may be worth considering.

Tubal ligation

Folks with fallopian tubes can have their tubes tied, blocked, or cut to stop eggs going from the ovaries to the uterus to prevent pregnancy

It’s more than 99 percent effective, but keep in mind that once done, reversing it isn’t easy or always possible. If there’s a chance you may want kids down the road, this may not be your best option.

PSA: Fertility awareness methods are reliable about 3/4 of the time

Those are some sketchy odds when it comes to birth control! With about 24 out of every 100 people becoming pregnant using the rhythm method, it’s worth looking into one of the many more effective and less anxiety-inducing options.

How to find an LGBTQIA+ friendly healthcare provider

You have a few options when it comes to finding a LGBTQIA+ competent healthcare provider, starting with word of mouth. Ask transgender friends for recommendations or hit up an online forum.

You can also:

• Speak to a healthcare professional at your local health department or sexual health center.
• Use OutList to find a provider in your area.
• Use the World Professional Association for Transgender Health (WPATH) provider directory.

For more support, take a look at our guide on finding an LGBTQ-friendly healthcare provider.

The bottom line

Birth control for men exists, but how many options you have comes down to your reproductive parts. There are some options coming down the pipeline for folks who have a penis and testicles, but it could be a while.

Until then, a chat with a healthcare professional — and maybe your partner(s), depending on your sitch — can help you come up with a solution that works for you.

Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.